Evolution of attitudes at US transplant centers toward kidney donation by friends and altruistic strangers

A severe shortage of organs is one of the major barriers facing transplanta tion today. One of the proposals designed to overcome this serious problem is to increase the use of genetically unrelated living kidney donors. Excel lent results have been achieved with these volunteers and cogent arguments have been made that this practice is ethically acceptable. These considerat ions have encouraged many transplant centers to break with tradition and ac cept spousal donors. To-see if there has been a similar change in attitudes toward other types of unrelated living donors, a survey was mailed to 208 U.S. renal transplant centers; 129 (62%) were returned. Ninety-three percen t of responding centers said they would accept a close friend as a kidney d onor. Although the majority of centers would not consider an altruistic str anger, a sizeable minority (38%) would. When compared with the results of p revious surveys, these data show that attitudes toward unrelated living kid ney donors have gradually become much more liberal.